{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:23:21Z","timestamp":1780323801003,"version":"3.54.1"},"reference-count":14,"publisher":"International Journal of Sports Physical Therapy","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"\n Background<\/jats:title>\n Patellofemoral conditions are common causes of knee symptoms in young and active individuals and have been linked in prior literature to neuromuscular and movement-related deficits that also have been associated with anterior cruciate ligament (ACL) injury risk. However, whether a prior diagnosis of patellofemoral conditions is associated with increased subsequent ACL injury risk remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To determine whether prior diagnosis of patellofemoral conditions (PFC) is associated with an increased risk of subsequent anterior cruciate ligament (ACL) injury or other intra-articular knee pathology.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Retrospective cohort study.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Electronic medical records from a multi-state health system were reviewed to identify patients aged 14\u201340 years with patellofemoral conditions (PFC) diagnosed between 2014 and 2016. Exclusion criteria included prior major lower extremity injury or surgery, systemic rheumatologic disease, and incomplete records. Identified patients were followed through 2024 for incident knee injuries or knee-related surgical procedures. The primary outcome tracked was incident ACL injury. Secondary tracked outcomes included meniscal, chondral, medial patellofemoral ligament, and other ligamentous injuries of the knee, as well as knee-related surgical procedures. Cumulative incidence was estimated, and risk factors were compared using Wilcoxon rank-sum, chi-square tests, and multivariable logistic regression adjusting for age, sex, and body mass index (BMI).<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Of 3,108 screened charts, 1,232 patients met inclusion criteria (median age: 19 years; 69.2% female). During the follow-up time period, 10.9% sustained an intra-articular knee injury or underwent a knee-related surgical procedure. ACL injuries occurred in 2.5% and meniscal injuries in 4.1%; less frequent events included medial collateral ligament injuries (0.7%), osteotomies (0.6%), and patellar tendon injuries (0.2%). The ACL incidence in this cohort was 246 per 100,000 person-years, a 3.6-fold higher rate compared with the general population. Injuries occurred predominantly ipsilateral to the index PFC diagnosis. In adjusted analysis, greater weight and BMI were associated with subsequent knee injury; however, multivariable logistic regression did not identify age, sex, or BMI as independent predictors of ACL injury.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Patients with patellofemoral conditions showed a substantially elevated incidence of subsequent ACL injury compared to the general population. A prior diagnosis of PFC may identify a subgroup at greater risk for later intra-articular knee injury and may warrant closer rehabilitation and injury-prevention consideration.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 3<\/jats:p>\n <\/jats:sec>","DOI":"10.26603\/001c.162094","type":"journal-article","created":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:25:02Z","timestamp":1780320302000},"source":"Crossref","is-referenced-by-count":0,"title":["Association between Patellofemoral Conditions and the Incidence of ACL Injury: Could Patellofemoral Conditions be a Risk Factor for ACL Injury? A 10-year Population-Based Study"],"prefix":"10.26603","volume":"21","author":[{"given":"Luke","family":"Bunch","sequence":"first","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony T","family":"Drazick","sequence":"additional","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ghislain","family":"Aminake","sequence":"additional","affiliation":[{"name":"Fowler Kennedy Sport Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chloe","family":"Roy","sequence":"additional","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin","family":"Biggs","sequence":"additional","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella","family":"Beltran","sequence":"additional","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy M.","family":"Burnham","sequence":"additional","affiliation":[{"name":"Ochsner-Andrews Sports Medicine Institute","department":["Orthopaedic Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"11140","published-online":{"date-parts":[[2026,6,1]]},"reference":[{"issue":"14","key":"ref1","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1136\/bjsports-2016-096328","article-title":"Patellofemoral pain during adolescence: much more prevalent than appreciated","volume":"50","author":"M. S. Rathleff","year":"2016","journal-title":"Br J Sports Med"},{"issue":"12","key":"ref2","doi-asserted-by":"publisher","first-page":"3146","DOI":"10.1177\/0363546516656373","article-title":"Utilization of ACL injury biomechanical and neuromuscular risk profile analysis to determine the effectiveness of neuromuscular training","volume":"44","author":"T. E. Hewett","year":"2016","journal-title":"Am J Sports Med"},{"issue":"4","key":"ref3","doi-asserted-by":"publisher","first-page":"492","DOI":"10.1177\/0363546504269591","article-title":"Biomechanical measures of neuromuscular control and valgus loading of the knee predict anterior cruciate ligament injury risk in female athletes: a prospective study","volume":"33","author":"T. E. Hewett","year":"2005","journal-title":"Am J Sports Med"},{"issue":"2","key":"ref4","doi-asserted-by":"publisher","first-page":"118","DOI":"10.1136\/bjsports-2013-092536","article-title":"High knee abduction moments are common risk factors for patellofemoral pain (PFP) and anterior cruciate ligament (ACL) injury in girls: Is PFP itself a predictor for subsequent ACL injury?","volume":"49","author":"G. D. Myer","year":"2015","journal-title":"Br J Sports Med"},{"issue":"5","key":"ref5","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1136\/bjsports-2017-098890","article-title":"Risk factors for patellofemoral pain: a systematic review and meta-analysis","volume":"53","author":"B. S. Neal","year":"2019","journal-title":"Br J Sports Med"},{"issue":"19","key":"ref6","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.2106\/jbjs.l.01705","article-title":"Societal and economic impact of anterior cruciate ligament tears","volume":"95","author":"R. C. Mather","year":"2013","journal-title":"J Bone Joint Surg Am"},{"issue":"48","key":"ref7","doi-asserted-by":"publisher","first-page":"1655","DOI":"10.15585\/mmwr.mm7048a1","article-title":"Economic sost of injury \u2014 United States, 2019","volume":"70","author":"C. Peterson","year":"2021","journal-title":"Morb Mortal Wkly Rep"},{"issue":"7","key":"ref8","doi-asserted-by":"publisher","first-page":"562","DOI":"10.1136\/bjsports-2016-097066","article-title":"Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes","volume":"51","author":"K. Thorborg","year":"2017","journal-title":"Br J Sports Med"},{"issue":"7","key":"ref9","doi-asserted-by":"publisher","first-page":"1003","DOI":"10.1177\/0363546504272261","article-title":"Effectiveness of a neuromuscular and proprioceptive training program in preventing anterior cruciate ligament injuries in female athletes: 2-year follow-up","volume":"33","author":"B. R. Mandelbaum","year":"2005","journal-title":"Am J Sports Med"},{"issue":"3","key":"ref10","doi-asserted-by":"publisher","first-page":"149","DOI":"10.5694\/mja2.52385","article-title":"The economics of a national anterior cruciate ligament injury prevention program for amateur football players: a Markov model analysis","volume":"221","author":"A. Ross","year":"2024","journal-title":"Med J Aust"},{"issue":"9","key":"ref11","doi-asserted-by":"publisher","first-page":"1325","DOI":"10.1007\/s40279-015-0353-4","article-title":"Biomechanics associated with patellofemoral pain and ACL injuries in sports","volume":"45","author":"K. Weiss","year":"2015","journal-title":"Sport Med"},{"issue":"1","key":"ref12","doi-asserted-by":"publisher","first-page":"e0190892","DOI":"10.1371\/journal.pone.0190892","article-title":"Incidence and prevalence of patellofemoral pain: A systematic review and meta-analysis","volume":"13","author":"B. E. Smith","year":"2018","journal-title":"PLoS One"},{"issue":"9","key":"ref13","doi-asserted-by":"publisher","first-page":"CPG1","DOI":"10.2519\/jospt.2019.0302","article-title":"Patellofemoral pain","volume":"49","author":"R. W. Willy","year":"2019","journal-title":"J Orthop Sports Phys Ther"},{"issue":"8","key":"ref14","doi-asserted-by":"publisher","first-page":"2582","DOI":"10.1016\/j.arthro.2021.03.030","article-title":"Higher meniscal slope is a risk factor for anterior cruciate ligament injury in skeletally immature patients","volume":"37","author":"E. V. Freitas","year":"2021","journal-title":"Arthroscopy"}],"container-title":["International Journal of Sports Physical Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/162094-association-between-patellofemoral-conditions-and-the-incidence-of-acl-injury-could-patellofemoral-conditions-be-a-risk-factor-for-acl-injury-a-10-y","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T13:25:02Z","timestamp":1780320302000},"score":1,"resource":{"primary":{"URL":"https:\/\/ijspt.scholasticahq.com\/article\/162094-association-between-patellofemoral-conditions-and-the-incidence-of-acl-injury-could-patellofemoral-conditions-be-a-risk-factor-for-acl-injury-a-10-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,1]]},"references-count":14,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.26603\/001c.162094","relation":{},"ISSN":["2159-2896"],"issn-type":[{"value":"2159-2896","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,1]]}}}